Antiretroviral therapy dramatically reduces mortality in HIV+ individuals, and poor adherence to medication is the major barrier to successful treatment. While there are several patient characteristics associated with non-adherence, depression is an easily identifiable and predictably modifiable barrier to adherence across several diseases. We propose a non-blinded randomized controlled trial to test the efficacy of antidepressant therapy to improve use of and adherence to antiretroviral drug therapy among HIV+ homeless and marginally housed depressed persons. The intervention group will receive antidepressant therapy at a storefront project site and the control group will be referred to standard mental health services in the community. We will examine five primary aims, including depression treatment, adherence to antiretroviral therapy, duration of sustained antiretroviral treatment, initiation of treatment, and viral suppression.